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  • is the drug of choice and is active against all schistosome species
  • acts within one hour of ingestion
  • can be used to treat young children (>4 years old) and pregnant women if breastfeeding is discontinued on the day of treatment and for the next 72 hours
  • dose
    • S haematobium, S mansoni, S intercalatum - 40 mg/kg per day, two doses a day by mouth
    • S mekongi - 60 mg/kg per day, three doses a day by mouth
  • resistance to the praziquantel has been reported in Africa due to heavy exposure to the drug

Adjuvant therapy

  • corticosteroids
    • prednisone 1.5-2.0 mg/kg per day for three weeks is used for treatment of
      • Katayama syndrome within two months of freshwater contact
      • schistosomal encephalopathy during the oviposition (egg laying) stage
    • together with anticonvulsants corticosteroids may be used as adjuvants to praziquantel in neuroschistosomiasis,
    • help to alleviate acute allergic reactions and to prevent mass effects caused by excessive granulomatous inflammation in the CNS (1).
  • anticonvulsant
    • used for seizures seen in cerebral schistosomiasis (lifelong use is rarely indicated)

Other antiparasitic agents

  • oxamniquine - for S mansoni (not effective against S japonicum)
  • metrifonate - for S haematobium (not effective against S japonicum)
  • mefloquine-artesunate - has shown promising results against S haematobium but further investigations are necessary


  • praziquantel cannot be used for chemoprphylaxis since it is ineffective against chistosomula (migrating larvae) that are three to 21 days old
  • artemethe
    • effective against juvenile schistosomes during the first 21 days of infection in animals and humans
    • all immature schistosomula should be killed if given every two weeks
    • efficacy of artemether based combination therapy is unclear


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